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慢性肠炎犬的高凝状态及其与血清白蛋白浓度的关系。

Hypercoagulability in dogs with chronic enteropathy and association with serum albumin concentration.

机构信息

Bristol Veterinary School, University of Bristol, Langford House, Langford, BS40 5DU, United Kingdom.

Small Animal Referral Hospital, Langford Vets, Langford House, Langford, BS40 5DU, United Kingdom.

出版信息

J Vet Intern Med. 2021 Mar;35(2):860-866. doi: 10.1111/jvim.16044. Epub 2021 Feb 1.

Abstract

BACKGROUND

Dogs with protein-losing enteropathy (PLE) are at risk of developing a hypercoagulable state, but the prevalence of hypercoagulability in dogs with chronic enteropathies (CE) and normal serum albumin concentration is unknown.

HYPOTHESIS

Dogs with CE are predisposed to a hypercoagulable state as assessed by thromboelastography (TEG) independent of serum albumin concentration.

METHODS

Dogs with chronic gastrointestinal signs from suspected inflammatory CE between 2017 and 2019 were included. Thirty-eight were evaluated; every dog had a CBC, serum biochemistry panel, and abdominal imaging performed. The Canine Inflammatory Bowel Disease Activity Index (CIBDAI) was calculated. Thromboelastography was performed at presentation, and reaction time (R), kinetic time (K), α-angle, maximal amplitude (MA), and global clot strength (G) were recorded. Dogs were considered hypercoagulable if the G value was ≥25% above the reference interval.

RESULTS

Seventeen of 38 (44.7%; 95% confidence interval [CI], 28.6-61.7%) dogs with CE were hypercoagulable. The G value did not differ between the 19 dogs with normal (≥28 g/L) serum albumin concentrations (9.05 kdyn/cm ; 95% CI, 7.26-10.84; SD 3.71) and 19 dogs with hypoalbuminemia (11.3 kdyn/cm ; 95% CI, 9.04-13.6, SD; 4.7; P = .11). The G value was negatively correlated with hematocrit, serum albumin concentration, and duration of signs and positively correlated with age.

CONCLUSIONS AND CLINICAL IMPORTANCE

Dogs with CE and normal serum albumin concentration can be hypercoagulable as measured by TEG.

摘要

背景

患有蛋白丢失性肠病(PLE)的犬存在发生高凝状态的风险,但慢性肠病(CE)且血清白蛋白浓度正常的犬发生高凝状态的患病率尚不清楚。

假设

通过血栓弹性描记术(TEG)评估,患有 CE 的犬存在易发生高凝状态的倾向,与血清白蛋白浓度无关。

方法

纳入 2017 年至 2019 年患有疑似炎症性 CE 的慢性胃肠道症状的犬。对 38 只犬进行了评估;每只犬均进行了全血细胞计数、血清生化分析和腹部影像学检查。计算犬炎症性肠病活动指数(CIBDAI)。在就诊时进行血栓弹性描记术,记录反应时间(R)、动力学时间(K)、α角、最大振幅(MA)和整体凝血强度(G)。如果 G 值比参考区间高 25%,则认为犬处于高凝状态。

结果

38 只患有 CE 的犬中,有 17 只(44.7%;95%置信区间[CI],28.6-61.7%)处于高凝状态。19 只血清白蛋白浓度正常(≥28 g/L;9.05 kdyn/cm;95%CI,7.26-10.84;SD 3.71)和 19 只低白蛋白血症(11.3 kdyn/cm;95%CI,9.04-13.6,SD;4.7;P =.11)的犬的 G 值无差异。G 值与红细胞压积、血清白蛋白浓度、症状持续时间呈负相关,与年龄呈正相关。

结论和临床意义

通过 TEG 测量,患有 CE 且血清白蛋白浓度正常的犬可能处于高凝状态。

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